Japan Food Allergy Findings – A summary
- Japan’s latest national food allergy survey shows tree nuts are now the second‑most common allergen, rising to 24.6% of cases.
- Tree nut allergies have increased continuously since 2014.
- Cashew nut allergies are rising fastest, prompting Japan to move cashews from “recommended” to mandatory allergen labelling.
- Macadamia (18.8%), pistachio (14.0%) and cashew (13.3%) nuts cause the highest rates of anaphylaxis among food allergies.
- Japan currently mandates allergen labels for eight foods and recommends labels for 20 others, with more nuts being reassessed for stricter regulation.
The Japanese government has conducted the Nationwide Survey on Health Damages caused by Immediate-Onset Food Allergies every three years since 2002.
This national food allergy survey has not stopped over the past 20-odd years, as it is deemed crucial to ensure food allergies do not increasingly affect public health – but results of the latest (2024) survey have unfortunately shown that tree nut allergies are emerging as a rising hazard for consumers.
“The top three foods causing allergies in the country are now eggs (26.7%), tree nuts (24.6%) and milk (13.4%), where tree nuts leaped past wheat and milk – which ranked second and third respectively in 2020 – to become the second most-common allergen causing harm in Japan,” Principal Investigator Motohiro Ebisawa from the Clinical Research Center, National Hospital Organisation Sagamihara Hospital Research said.
“The number of cases involving tree nuts has increased significantly, and analysis by nut type has shown that walnuts alone had more reported cases (916 cases) than milk (807 cases).”
Previous data since 2005 has shown a stabilisation and even reduction in the number of allergic cases caused by eggs, milk and wheat – but there has been a continuous increase in tree nut cases since 2014, prompting the need for immediate action.
Among these, cashew nuts have shown the largest growth in allergy case numbers, leading the Japanese Consumer Affairs Agency (CAA) to convene a government-level food allergy labelling council to implement mandatory allergen warnings for this nut.
Nut allergy cases on the rise between 2020 and 2024
- Walnuts have leaped from 7.6% to 15.2% of allergy cases, a growth of roughly 2x
- Cashew nuts increased from 2.9% to 4.6%, an increase of approximately 1.6x
- Macadamia nuts increased from 0.7% to 1.1%, an increase of roughly 1.5x
- Pistachios increased from 0.4% to 0.8% in the previous survey, roughly 2x growth
- Pecans increased from 0.3% to 0.6%, approximately 2x growth
“The recent 2024 national food allergies survey has shown that cases caused by cashew nuts are on the rise, and we believe this is not a temporary phenomenon,” CAA Food Labelling Division Director Ikuo Miyanaga .
“Thus far, cashew nuts have only been on the list of food items [recommended for allergen labelling] – in response to these results, the council believes that it is appropriate to move cashew nuts from the recommended list to the [mandatory allergen labelling list] in order to ensure consumer safety.”
Anaphylactic shock risks
Concerningly, a high proportion of food allergy cases leading to anaphylaxis are linked to tree nuts, the highest of which are macadamia nuts (18.8%), pistachios (14.0%) and cashew nuts (13.3%).
Anaphylaxis is a severe, life-threatening allergic reaction as the associated shock symptoms cause the immune system to go into overdrive, leading to consequences such as difficulty breathing, hives, fainting or even death if severe.
Pistachios will also be added to the recommended list for labelling, given the rise of cases related to this nut.
“Macadamia nuts, pistachios, cashews and other nuts often cause anaphylactic shock symptoms, so measures must be taken promptly to avoid risk and prevent accidental ingestion,” the report stated.
Food allergy management in Japan
In Japan, food items on the recommended list are called ‘specified raw material equivalents’ whereas those on the mandatory list are termed ‘specified raw materials’.
There are currently eight items on the mandatory list and 20 on the recommended list.
| Recommended list | Mandatory list |
|---|---|
| Almond Abalone Squid Salmon roe Orange Cashew nuts Macadamia nuts Kiwifruit Beef Sesame seed Salmon Mackerel Soybean Chicken Banana Pork Peach Wild yam Apple Gelatin | Shrimp Crab Eggs Milk Peanuts Soba (Japanese buckwheat) Walnuts Wheat |
All allergens used in a food product must be indicated in brackets in nutrition labels, such as (soybean) if used.
